fitness

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Exercise per se may not protect us from sitting-related disease, but being fitter may. (Paul Haeberlin/Flickr)

“Be fit to sit is the answer!” the press release from the American College of Sports Medicine tells us.

And it’s an answer I must say I like very much. Because, as someone who likes to work out but also to sit most of the day, I did not like earlier studies suggesting that exercise cannot offset the mounting evidence that prolonged sitting is bad for us.

See, for example, this Daily Mail headline, with its emphatic upper case: “Exercising regularly WON’T offset the risk of sitting for long periods of time: An hour of activity a day isn’t enough to stave off heart disease, diabetes and cancer, study finds.”

But the research machine rolls on, and now a new Norwegian study in the journal Medicine & Science in Sports & Exercise adds another piece to the puzzle: It suggests that in fact, exercise per se may not protect us from sitting-related disease, but being fitter may.

In other words, it may not be enough to get plenty of physical activity if it’s so gentle it doesn’t affect your fitness; but if it’s moderate or vigorous enough — like interval training — to raise your fitness level, it may in fact protect you.

Researcher Javaid Nauman summarized the study and its findings in an email. The message, Nauman says, is that “people who sit for long periods of time need to exercise and improve their fitness. This is done by completing aerobic exercise at a moderate intensity or higher. Physical activity that has no effect on fitness will do little to protect against the harms of sitting.”

Prolonged sedentary time is associated with cardiovascular risk factors independent of physical activity. Whether a high level of cardiorespiratory fitness can modify the deleterious health consequences related to high sedentary time is not known.

We conducted a cross-sectional study of 12,274 men and 14,209 women (≥20 years) without known cardiovascular disease. Each hour increase in sedentary time was associated with 5% and 4% greater likelihood of having a cardiovascular risk factor clustering independent of physical activity in men and women, respectively. And more than seven hours of sitting per day increased the risk of cardiovascular risk factor clustering by 35%. Continue reading →

Confession: I didn’t know this was already a thing. I thought it was still purely my fantasy: I lie down on a padded table and tell the electrode technician, “Please give me the equivalent of an hour of CrossFit.” Then I relax as my muscles and nerves are zapped into activity that approximates an actual workout, but sweat-free.

I’m filing that fantasy away with my hopes for a pill that will someday activate my brown fat so brilliantly that the need for actual exercise is utterly obviated. Because a letter just out in the journal BMJ warns that the relatively novel practice of “whole-body electrical stimulation” at the gym can land you in the hospital with rhabdomyolysis, or muscle breakdown.

(Of course, non-electric CrossFit can apparently lead to the dreaded “Uncle Rhabdo” too, if you really overdo it. Also, I should note that the electrical stimulation discussed inthe BMJ letter is the kind used during a workout, not instead of one as in my fantasy.)

The letter, titled “It’s time to regulate the use of whole-body electrical stimulation,” opens with the background:

Transcutaneous electrical stimulation (ES) of human nerves and muscles has long been used as a non-pharmacological treatment for pain relief, and for rehabilitation after disuse. Whole body ES has recently emerged as an alternative form of physical exercise for improving fitness and health in healthy people. Despite limited scientific evidence on the safety and effectiveness of this form of exercise, several ES company sponsored fitness centers have recently been opened in different countries worldwide, making this technology easily accessible to the general population.

Now for the no-free-lunch part:

On 4 August 2015, a 20-year-old man presented to our hospital with severe muscle pain shortly after a session of gym based whole body ES exercise supervised by a fitness professional. Rhabdomyolysis was diagnosed, and he was treated with intravenous 0.9% saline for five days.

In Israel, a TV documentary publicized the potential risks of electrical stimulation, reporting that thousands of Israelis have tried it. The BMJ letter notes that several problematic cases have arisen and the Health Ministry issued an official public warning against the practice in January. The warning said bluntly: “The devices must not be used in gyms. Use without medical supervision could cause danger to health.”

The BMJ letter suggests that other health authorities follow suit. I asked its senior author, Dr. Nicola Maffiuletti, head of the Human Performance Lab at the Schulthess Clinic in Zurich, three quick questions by email:

Do you happen to know how common it has become for gyms to offer electrical muscle stimulation, and has it arrived in the United States yet?

Maffiuletti: “‘Whole body EMS’ is increasingly offered worldwide, also in the U.S. (there are three main brands that are distributed in more than 40 countries worldwide, including the U.S.). As an example, more than 500 centers have been opened in Spain in the last five years that offer whole body EMS. (Spain is one of the countries where EMS is more used.)”

What is the science on whether EMS actually works to replicate the effects of exercise? Is there any good research on that? How does the actual science compare with the marketing/advertising claims? Continue reading →

Feeling a bit bloated and sluggish after Thanksgiving weekend? A major study just out in the journal JAMA Internal Medicine offers an added nudge to get back on the exercise wagon. How fit you are even in your 20s, the study finds, can dramatically affect your risk of heart disease and death well into middle age.

So dramatically, in fact, that every minute matters.

Imagine you’re doing a stress test on a treadmill. Every two minutes, the machine makes you go faster and at a steeper incline. The first few minutes are no sweat — you’re walking, then trotting, then jogging — but soon you start to suck air, and finally hit the point that you can bear no more. (Or you may reach the 18-minute maximum, if you’re superhuman.)

Say you did that test in your 20s. Now fast-forward 25 years. The study found that every extra minute you could last on the treadmill meant you were at a 15 percent lower risk of death over that quarter-century, and at a 12 percent lower risk of harmful effects of heart disease, including stroke and heart attack.

“That’s a lot,” I found myself saying in a phone interview with the study’s two lead authors, Dr. Ravi V. Shah, of Harvard Medical School and Beth Israel Deaconess Medical Center, and Dr. Venk Murthy of the University of Michigan.

Though, of course, it must be noted that the overall risk of heart disease and death are relatively low in such a young population. Among the 4,872 people in the study, 273 died, but 200 of those deaths had no relation to heart disease. And just 4 percent of the study’s subjects had a “cardiovascular event” like a heart attack.

Still, the results cast new light on just how much fitness matters for heart health — even in our 20s, when many of us can still get away with a sleepless all-nighter or an all-weekend TV binge.

This new research is the first large study to examine people in their 20s onward over such a long period, the lead authors say, and underscores the importance of starting good fitness habits early — not just in later years, when the health price of inactivity is already well known.

The study also found that the heart benefits of fitness held true independent of weight and other heart risk factors. That suggests, Dr. Shah said, that “being fit is important for everyone, not just for people who are trying to lose or maintain weight.”

The study — an epic endeavor that began back in the mid-1980s and was led by four universities, including Harvard and Johns Hopkins — also suggests that early trajectory matters. That is, typical as it may be, it is not a good idea to let your fitness decline in your 20s.

Nearly 2,500 of the subjects underwent a second treadmill test just seven years after the first. For every minute less that they could last compared with their first test, their risk of death in the coming years went up by 21 percent, and their risk of heart disease by 20 percent.

And one other, particularly fascinating finding: Fitness as reflected by treadmill performance did not seem to matter for an accepted measure of heart health, the accumulation of calcium deposits in the arteries that supply the heart. Continue reading →

July 28, 2015 | 3:29 PM | Kate Lowenstein and Ramika Smith

We have a suggestion for how to spend some of the billions of dollars that Boston will likely save by not hosting the Olympics: How about we invest even 1 percent of that into the bodies and brains of our children by ensuring they get ample physical education and recess time?

Instead of spending billions to have elite adult athletes playing sports in our city, we can at least give our own Boston Public Schools kids the chance to run and play here.

Most parents of kids in the city’s public schools assume their children get recess every day, as we did when we were kids, but the reality turns out to be quite different. While the CDC recommends that all children get at least 60 minutes of vigorous exercise every day, and at least 30 minutes of school-time physical activity, many of our schools allow for as little as 20 minutes, if that.

Over the past two decades, accelerated by No Child Left Behind’s focus on testing, the tendency has been to reduce or eliminate physical education and recess. And our school administrators and legislators look the other way without recognizing the overwhelming amount of evidence that shows the significant academic and mental health benefits of these physical activity breaks.

Recess and physical education are as integral to a long school day as are Math, Science, and English.

In January of 2009, the journal Pediatrics published a groundbreaking study of 11,000 third-graders, comparing those who had little or no daily recess with those that had more than 15 minutes of recess per day. The findings show that children who have more recess time behave better in the classroom and are likelier to learn more.

It also underscored what we already know from many other studies; that children in schools that provide an adequate amount of time and opportunity (and encouragement) for daily physical activity, in the form of recess, gym classes and movement breaks, have higher MCAS scores in both math and ELA. Continue reading →

July 24, 2015 | 5:00 PM | Marina Renton

Whittier Street Health Center opened its community vegetable garden on June 24. (Courtesy of Chris Aduama)

By Marina Renton
CommonHealth Intern

When it comes to health in Boston, it’s hard to deny there’s a great divide across neighborhoods.

Need proof? A 2013 Boston Public Health Commission report found that, from 2000 to 2009, the average life expectancy for Boston residents was 77.9 years. But in the Back Bay, it was higher — 83.7 years — compared to Roxbury, where the average life expectancy was 74.

If you want to get even more local, you can analyze the same data by census tract, where life expectancy varies by as many as 33 years: 91.9 years in the Back Bay area between Massachusetts Avenue and Arlington Street, and 58.9 years in Roxbury, between Mass. Ave. and Dudley Street and Shawmut Avenue and Albany Street. That’s according to a 2012 report from the Center on Human Needs at Virginia Commonwealth University in Richmond.

The Whittier Street Health Center in Roxbury is trying to tackle the disparities in a very concrete way. With the launch of a new fitness club and community garden, the center is trying to make healthy food and exercise opportunities available and affordable to all, despite geography.

“What we’re trying to do is to remove those social determinants and barriers that are causing these [health] disparities,” said Frederica Williams, president and CEO of the health center.

‘If I Sweat, I’m Doing Something Right’

The fitness club and garden initiatives just launched June 27, but the Whittier Health and Wellness Institute is already drawing in community members.

Eight months ago, Wanda Elliott weighed 256 pounds. On a visit to her Whittier Street physician, she learned her blood pressure was high — high enough that she had to start taking medication. That was the wake-up call that motivated her to change her diet and start exercising.

“I was dragging,” she said.

Elliott began exercising at a local Y but joined the Whittier Street fitness club when it opened. In eight months, she has lost 52 pounds, leaving her 4 pounds shy of her 200 pound goal weight.

“I have two knee replacements, so I have to keep active every day,” she said. Trainers at the center helped her learn to use the exercise machines, and now it feels like a routine, she said.

“I feel addicted to working out. I feel like if I sweat, I’m doing something right,” she said. “From 256 to 204, I feel like a model. I can walk the runway; that’s how energized I feel now.”

Elliott is now off her blood pressure medication. She is working on making changes to her diet “slowly but surely,” drinking more water, eating more salad, and cutting back on red meat. Continue reading →

If you’re like me, this bout of November weather in June provides yet another excuse to ratchet back your exercise regime. And that means more sitting. Do not give in. Here, two more reports underscore the perils of sitting, one from the U.K. and one out of New York City.

In the U.K., sedentary behavior “now occupies around 60% of people’s total waking hours in the general population, and over 70% in those with a high risk of chronic disease. For those working in offices, 65–75% of their working hours are spent sitting,” according a new study published online in the British Journal of Sports Medicine.

cell105/flickr

To try to get workers off their bums, public health experts issued a consensus statement urging periodic stand-up breaks during the day.

According to the panel backing the new recommendations:

…for those occupations which are predominantly desk-based, workers should aim to initially progress towards accumulating 2 hours a day of standing and light activity (light walking) during working hours, eventually progressing to a total accumulation of 4 hours a day… To achieve this, seated-based work should be regularly broken up with standing-based work, the use of sit–stand desks, or the taking of short active standing breaks.

Along with other health promotion goals (improved nutrition, reducing alcohol, smoking and stress), companies should also promote among their staff that prolonged sitting, aggregated from work and in leisure time, may significantly and independently increase the risk of cardiometabolic diseases and premature mortality.

Even New Yorkers, who live in one of the best walking cities on the planet, are sitting far longer than what’s considered healthy, according to a new study by the U.S. Centers for Disease Control and Prevention and researchers at New York University, published in the journal Preventing Chronic Disease.

Researchers found great differences among various demographics — surprisingly, higher income folks spent more time sitting compared to those with lower incomes. Continue reading →

The venerable Institute of Medicine came out with a report this week on cognitive aging (yes, that means you…) and a few things that can help avert the inevitable. The panel’s No. 1 recommendation? “Be physically active.” Enough said.

To be clear, “cognitive aging is not a disease,” the report notes. “Instead, it is a process that occurs in every individual, beginning at birth and continuing throughout the life span.”

That process impacts the brain like no other body part, the authors say. And while the extent and quality of cognitive aging (read: decline) varies greatly, many older men and women will experience problems related to the speed at which they process information, the ability to problem-solve and make decisions and, of course, memory. (Lost keys, anyone?)

Putting a little silver lining on things, the IOM news release quotes the chairman of the committee, Dan G. Blazer, the J.P. Gibbons Professor of Psychiatry Emeritus at Duke University Medical Center, saying that “…wisdom and knowledge can increase with age, while memory and attention can decline.”

· Regularly discuss and review health conditions and medications that might influence cognitive health with a health care professional. A number of medications can have a negative effect — temporary or long term –on cognitive function when used alone or in combination with other medication.

The committee also identifies additional actions for which there is some scientific evidence to suggest positive effects on cognitive health:

· Be socially and intellectually active, and continually seek opportunities to learn.

· Get adequate sleep and seek professional treatment for sleep disorders, if needed.

· Take steps to avoid a sudden acute decline in cognitive function, known as delirium, associated with medications or hospitalizations.

If your resolutions included a re-energized commitment to cardio, you might want to reconsider your program.

A recent study by researchers at the Harvard School of Public Health reports that for men over 40, aerobic exercise alone may not be enough to rid you of your ring around the middle.

The study, published in the journal Obesity, found that men who did 20 minutes of daily weight training gained less abdominal fat than men who did 20 minutes of daily aerobic activity. A combination of cardio and weight training led to optimal results. Continue reading →

January 1, 2015 | 7:51 AM |

You know the drill. Lose weight. Save more money. Keep in better touch. Or as one of my Facebook friends recently announced “make a new piece of clothing every month.”

I hate the gym in January since it’s crowded to the gills with exercise hopefuls. By February, the regulars reign again and the wait for the treadmill is nonexistent.

A study published in the Journal of Clinical Psychology from researchers at the University of Scranton found that 45 percent of us made New Year’s Resolutions in 2014–and almost 90 percent of us failed at keeping them.

Maybe not a huge surprise but what can we do to maintain those good intentions?

First, is change even necessary? Do you already work out three days a week and now you’re promising to do six? It’s a worthwhile goal but acknowledge what you already do. “We don’t always have to be striving for perfection or feel like we’re a work in progress,” Levendusky writes.

Next, remember that small changes can make a big impact. Do you want to be a better partner? Instead of creating a list of 10 promises, start with something actionable and attainable–like being a better listener during dinner. According to Levendusky, “building goals that can have an immediate and positive response,” may actually help keep you on track beyond the month of January.

December 31, 2014 | 6:42 AM | Grace Clackson

In recent years, exercise was not on my radar. Like many others, I was busy balancing work and family. Honestly, I thought regular gym dates were only for overweight people. It wasn’t always this way — I loved dancing growing up but just couldn’t make room for it in my adult life.

But all of that changed in 2010.

I found myself more and more fatigued and around the same time my mother died from polycystic kidney disease (PKD), I learned I too had inherited the genetic kidney disorder. Most people with PKD, a chronic kidney disease where clusters of cysts develop primarily within the kidneys, get the disease between their 50’s and 60’s.

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Massachusetts is the leading laboratory for health care reform in the nation, and a hub of medical innovation. From the lab to your doctor’s office, from the broad political stage to the numbers on your scale, we’d like CommonHealth to be your go-to source for news, conversation and smart analysis. Your hosts are Carey Goldberg, former Boston bureau chief of The New York Times, and Rachel Zimmerman, former health and medicine reporter for The Wall Street Journal.

If they’re so effective, why aren’t more women using IUDs and implants? A health clinic in Worcester is getting help to put better birth control front and center — particularly long-acting birth control, in hopes of cutting the high rate of unintended pregnancy.